Thursday, November 21, 2013

UPDATE V: "Obamacare’s Medicaid expansion, for instance, is going perfectly well in states that chose to accept it. . .

[I]ndeed, the argument for a broader single-payer health-care system is very much intact. Instead, the elements of Obamacare that are failing are precisely those market-based initiatives that Republicans most want to work."

"[T]he worst features of Obamacare are the very features that conservatives want to impose on all federal social policy: means-testing, a major role for the states, and subsidies to private providers instead of direct public provision of health or retirement benefits. This is not surprising, because Obamacare’s models are right-wing models — the Heritage Foundation’s healthcare plan in the 1990s and Mitt Romney’s “Romneycare” in Massachusetts.

This point is worth dwelling on. Conservatives want all social insurance to look like Obamacare. The radical right would like to replace Social Security with an Obamacare-like system, in which mandates or incentives pressure Americans to steer money into tax-favored savings accounts like 401(k)s and to purchase annuities at retirement, with means-tested subsidies to help the poor make their private purchases. And most conservative and libertarian plans for healthcare for the elderly involve replacing Medicare with a totally new system designed along the lines of Obamacare, with similar mandates or incentives to compel the elderly to buy private health insurance from for-profit corporations. . .

UPDATE III: "It got buried beneath an avalanche of Obamacare scrutiny and
anti-Obamacare spin, but the most revealing statement about the future
of the Affordable Care Act yesterday came in the form of a flustered
conversation between a CNN host and Rep. Renee Ellmers, R-N.C.

[H]ere’s the short version.

An
unusual arrangement in the commonwealth of Kentucky gave Democratic
Gov. Steve Beshear the power to implement the Affordable Care Act almost
by fiat. And he did it. The ironic consequence is that one of the most
conservative states in the country, surrounded by states that have by
and large tried to obstruct the law, now has one of its best functioning
insurance exchanges, Kynect.

Because it was developed
independently from Healthcare.gov — and because Beshear’s administration
took great care to make the law work for skeptical constituents —
Kynect customers seem to be happy and are signing up by the thousands.

Ellmers’
North Carolina doesn’t share a border with Kentucky but it’s safe to
call it a neighboring state. Its population as a whole is less
conservative than Kentucky’s, but it’s governed by conservative
hard-liners. So it’s no surprise that Ellmers hates Obamacare and uses
Healthcare.gov’s inauspicious launch to bolster the case that it should
be repealed.

What’s revealing is that when asked to contend with
Obamacare’s relative success across a couple of borders in Kentucky, she
plunges into gibberish. She can’t even begin to grapple with it. . .

[These examples show that the U.S. may soon have a] two-tiered healthcare system. One, for most people, that would work
pretty well. Another highly dysfunctional one for post-policy
conservatives, which would either last until the feds get it right, or
slowly shrink over time as states recognized how pointless the stand
they were taking really was."

UPDATE II: "The classic definition of chutzpah is the child who kills his parents
and then asks for leniency because he's an orphan. But in recent weeks,
we've begun to see the Washington definition: A party that does
everything possible to sabotage a law and then professes fury when the
law's launch is rocky."

"Washington was shut down because Republicans don't want Obamacare. On
the other hand, Obamacare was nearly shut down because so many Americans
wanted Obamacare. . .

This is, of course, precisely what Republicans were scared of: That a
law they loathe would end up being enthusiastically embraced by millions
of Americans -- and thus proving permanent. It's Obamacare's possible
success, not its promised failures, that unnerve the GOP. . .

[M]illions of Americans have been waiting for something like Obamacare,
and now that they've got it, they're going to want to keep it."

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